GLP-1 Drugs Don't Increase Complications After Shoulder Surgery, Meta-Analysis of 43,000 Patients Finds | Research

The takeaway

A meta-analysis of over 43,000 patients found no significant increase in adverse events following shoulder surgery among GLP-1 agonist users, with arthroscopic procedures actually showing lower complication rates.

No significant risk increase
Among 43,415 shoulder surgery patients, GLP-1 users had statistically similar complication rates to non-users at both 90 days and 2 years after total shoulder replacement

What the researchers found

For total shoulder arthroplasty (TSA), the pooled 90-day complication rate was 18.1% for GLP-1 users versus 15.9% for non-users, with no statistically significant difference (OR = 0.86, 95% CI: 0.36–2.07, P = 0.74). At 2 years, rates were nearly identical: 3.8% vs 3.7% (OR = 1.24, 95% CI: 0.73–2.00, P = 0.42).

For arthroscopic procedures, GLP-1 users showed notably lower 90-day complication rates. After rotator cuff repair, complications were 11.0% vs 27.4% in non-users. After capsular release for adhesive capsulitis, rates were 2.5% vs 4.8%. Re-tear rates after rotator cuff repair were also lower in GLP-1 users at 2 years (12.5% vs 18.3%), though these arthroscopic findings were from limited studies described narratively rather than pooled.

Why it matters

With GLP-1 drugs becoming some of the most prescribed medications in the world, millions of users will need surgery at some point. Surgeons and patients need reliable data on whether these drugs affect surgical outcomes. This study provides reassurance that GLP-1 use does not increase shoulder surgery complications, which is particularly important given concerns about wound healing and tissue quality in patients taking weight-loss medications.

How the study worked

The researchers conducted a PRISMA-compliant systematic review and meta-analysis, searching PubMed, Embase, and Scopus through August 2025. They included Level I–III comparative studies that assessed postoperative adverse events in GLP-1 users vs non-users after total shoulder arthroplasty or arthroscopic shoulder procedures. Random-effects meta-analyses were performed for the four TSA studies, while the two arthroscopic studies were described narratively due to limited data. Outcomes included 90-day and 2-year complication rates.

What this study cannot tell us

Only six studies met inclusion criteria, and the arthroscopic findings couldn't be meta-analyzed due to limited data. The studies were observational, not randomized controlled trials, so confounding factors may influence results. GLP-1 users likely differed from non-users in baseline characteristics beyond the adjustments made. The study couldn't determine specific GLP-1 drugs, doses, or duration of use. Publication bias is possible given the topic's novelty.

How to read the evidence

This is a systematic review and meta-analysis of Level I–III studies, which represents a high level of evidence synthesis. However, the included studies were observational, the arthroscopic data couldn't be formally pooled, and the overall number of included studies (six) is modest.

When this study was published

Published in 2026 with a literature search through August 2025, this is among the first meta-analyses to address GLP-1 safety in shoulder surgery and reflects the most current data available.

The bigger picture

This study adds to growing evidence that GLP-1 drugs don't harm — and may even help — surgical outcomes. Previous research showed reduced complications after hip and knee replacements in GLP-1 users. The potential benefits for arthroscopic procedures (lower re-tear rates, fewer complications) align with emerging research suggesting GLP-1 agonists may have anti-inflammatory and tissue-healing properties beyond their metabolic effects. As GLP-1 prescribing continues to surge, these surgical safety data will be critical for clinical decision-making.

Questions still open

Do the lower complication and re-tear rates after arthroscopic procedures reflect a direct tissue-healing benefit of GLP-1 drugs, or are they confounded by better overall health management in GLP-1 users?
Should GLP-1 drugs be continued, paused, or dose-adjusted around the time of surgery for optimal outcomes?
Would longer follow-up or larger arthroscopic studies confirm the trend toward better tendon healing in GLP-1 users?

Common questions

Should I stop my GLP-1 medication before shoulder surgery?

This meta-analysis found no increase in complications for GLP-1 users after shoulder surgery, suggesting these drugs should not be considered a reason to avoid or delay surgery. However, some anesthesiologists recommend pausing GLP-1 drugs briefly before surgery due to concerns about delayed gastric emptying and aspiration risk during anesthesia. Always follow your surgeon's and anesthesiologist's specific guidance.

Could GLP-1 drugs actually help with tendon healing after rotator cuff repair?

The data hints at this possibility — GLP-1 users had lower re-tear rates (12.5% vs 18.3%) and fewer complications after rotator cuff repair. However, these findings come from limited studies and could be explained by other factors. Some researchers hypothesize that GLP-1 drugs' anti-inflammatory effects may benefit tissue healing, but this hasn't been confirmed in controlled trials.

Read the original research

GLP-1 receptor agonist therapy is not associated with adverse events following shoulder surgery: a systematic review and meta-analysis.

Journal of shoulder and elbow surgery

View on PubMed ↗Publisher’s paper ↗

Citation

Moews, Logan D; Kunze, Kyle N; Thamrongskulsiri, Napatpong; Vega, Tomas F; Morgan, Jacob T; Nishioka, Tanner; Chahla, Jorge; Verma, Nikhil N. (2026). GLP-1 receptor agonist therapy is not associated with adverse events following shoulder surgery: a systematic review and meta-analysis.. Journal of shoulder and elbow surgery. https://doi.org/10.1016/j.jse.2025.12.005